Multimodality approach in the diagnosis and management of bilateral giant juvenile breast fibroadenoma

Abstract

Juvenile giant fibroadenoma is a very rare breast disease affecting young girls of premenarche and adolescent ages. It is a benign fibroepithelial tumour characterised by stromal and epithelial proliferation that causes rapidly growing breast mass. Bilateral symmetrical involvement is extremely rare. In this article, we describe this entity in a girl aged 13 years who presented with bilateral gigantically enlarged breasts. Ultrasonography and MRI showed large, multilobulated masses involving both breasts entirely. Endovascular embolisation of bilateral internal mammary arteries and lateral thoracic arteries supplying the masses was performed prior to surgery to reduce their vascularity. The patient subsequently underwent excision of bilateral breast masses and reduction mammoplasty. Histopathologically, bilateral breast masses were confirmed to be juvenile fibroadenomas.

Mammotome-assisted removal with minimal incision of large juvenile fibroadenoma of breast

“…[ 6 ] Varying techniques in surgical extirpation have been described in order to optimize esthetics and minimize distortion. These include video-assisted endoscopic extirpation with and without morcellation, [ 7 ] “Swiss-roll” technique, [ 8 ] “Saw Tooth” operation, [ 9 ] circumareolar incision with T-shaped or lateral extension, [ 10 ] a sub-mammary incision, [ 11 ] endovascular embolization before operation, [ 12 ] reduction mammaplasty, and mastectomy. [ 13 ] A breast incision should be performed after taking into account not only the standard of care for giant juvenile fibroadenomas with preservation of maximal breast tissue but also the cosmesis.…”

Breast-conserving surgery in giant juvenile fibroadenoma: a case report

“…Endovascular embolization of the internal mammary arteries and the lateral thoracic arteries supplying the tumors have been performed before surgery to reduce their vascularity and the risk of bleeding (12).…”

Atypical Fibroadenoma Presentation of a Case

“…Other authors report their age of onset, between the ages of 20 and 35 years of age [5]. However, this type of injury is unlikely to appear in postmenopausal women [5,6].…”

“…The size ranges from a few millimeters to several centimeters (most are 1 to 3 cm). In those very small lesions, the diagnosis is a fortuitous fi nding [6][7][8][9].…”